Patient Navigator (H)

Remote work from the Medley, FL office.

About the Role

The Patient Navigator facilitates patients’ ability to obtain services by identifying barriers to care, coordinating the development of treatment plans, and monitoring the implementation and follow-up of services ordered by caregivers.

Responsibilities

• Conducts patient evaluations to obtain information necessary for the development of an effective treatment plan.
• Ensures patients have access to insurance and social service programs for which they are eligible.
• Provides patient reminders of upcoming appointments and acts as liaison between patients and providers.
• Identifies and resolves real or perceived barriers to care.
• Educates and counsels patients on issues related to their health and life situations.
• Maintains current knowledge of community health, welfare resources, and any other programs available to patients.
• Adheres to University and unit-level policies and procedures and safeguards University assets.
• Maintains a working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate type and urgency of medical need.
• Maintains knowledge of insurance referral requirements to ensure access based on third-party reimbursement criteria.
• Ensures that the appropriate appointment and registration information is documented at time of scheduling.
• Adheres to policies and procedures regarding appointment scheduling and registration processes, performing these tasks accurately with attention to detail to ensure the highest quality standards.
• Adheres to standards provided by the HIPAA Privacy Office related to patient privacy and confidentiality.
• Initiates pre-registration process and coordinates with the Central Insurance Verification and Patient Access teams to assure pre-registration in the appropriate facility prior to the appointment.
• Provides verification of enrollment and deductible status for persons enrolled in the School's special contract programs.
• Notifies appropriate parties of the appointment time, referral criteria, insurance verification, and prior authorization requirements.
• Contacts insurance company through telephone; inquires about patient information and benefits.
• Inquires via insurance companies and HMOs about referral, authorization information, and letters.
• Intervenes as liaison/advocate for patients, physicians, and staff in facilitating ease of care.
• Assists in identifying trouble spots and problem patterns in the provision of care.
• Intercedes for the patient as needed to obtain prompt, efficient, effective care (e.g., medical explanations, reduced waiting, billing inquiries, cost estimates).
• Builds partnerships with local community physicians and referral sources to the UHealth Systems.
• Maintains communication with patients and the healthcare providers to monitor patient satisfaction with the patient care experience.
• Arranges any special needs such as transportation, interpreting services, etc., as needed for the patient’s appointment.
• Facilitates financial support, assistance with paperwork or medical records, and linkage to follow-up services.
• Prepares routine departmental correspondence to referring agencies and primary care providers.
• Serves as a liaison between the patients, the UHealth Systems, and Medical Providers to increase the utilization of appropriate primary care and tertiary services.
• Works to maximize patient use of appropriate and established health services, assists and guides patients in receiving medical services, educates patients on the appropriate utilization of care, appointments, and treatment services, and ensures that patients are able to access and keep medical appointments.
• Handles appointment setting and referral management as defined.

Requirements

• High School diploma or equivalent required.
• Minimum 3 years of relevant work experience required.
• Ability to process and handle confidential information with discretion.
• Ability to communicate effectively in both oral and written form.
• Ability to handle difficult and stressful situations with professional composure.
• Ability to maintain effective interpersonal relationships.
• Ability to understand and follow instructions.

Benefits

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, and tuition remission.